Panos Global AIDS Programme Georgetown, Guyana It has been reported ad nauseum in the media over the years that Guyana 's prisons are overcrowded and that this not only threatens security, law and order, but also the health of prison populations and by extension the general public. This is multiplied when there is sex in prison — consensual or not.
The Georgetown Prison, Guyana
There is a large number of remand prisoners — about 800 — in the Georgetown Prison.
Chaplain of the Guyana Prison Service Reverend Faye Clarke said that there are many programmes to address HIV in the prisons. "We have VCT (voluntary counseling and testing) sites at the Georgetown Prison and at all other locations. We have had ongoing programmes since 1999 and these are being continuously expanded," she said.
Reverend Clarke said that an area in the Lusignan Prison on the East Coast of Demerara has been funded through the World Bank to address the care of HIV positive inmates and for the supply of supplemental dietary items.
Guyana's National HIV/AIDS Strategy 2007 – 2011 called prisoners one of the marginalized sub-groups, along with men who have sex with men (MSM) and commercial sex workers (CSWs). This strategy said that for the fight to be effective, recognition must be given to the special needs of these groups as part of the guiding principles of a multisector response.
Evidenced-based
Leslie Ramsammy, Minister of Health, Guyana
"Whatever we do in Guyana is evidence-based and this is not just us pulling things out of the air. If you look at any country where studies have been done, in Africa, in Asia, in Latin America, in the Caribbean, we see that populations in prisons have an HIV prevalence that is higher than the prevalence in the general population," said the minister.
"And when you look at the situation in Guyana we see the same thing…this is not about hearsay or speculation. We have done the study," he said. According to Biological and Behavioural Surveillance Survey in 2007, the prevalence rate among prisoners in Guyana was 5.24 percent.
He said that while in many other countries the rate of infection among the prison population is about four times higher than that of the general population, the rate is about two times higher for Guyana 's prison population.
"This being the case, it would be morally irresponsible on our part [to not address health in prisons] since the vast majority of these prisoners are going to come out and return to the society," he said.
He said that the programme for the prisons is a comprehensive one that includes prevention — the foundation of which is education and awareness — regular testing and counseling. "As part of the prevention programme we recognize that drugs and alcohol represent a major risk and for that reason we have introduced, in all but one prison, a substance abuse programme," the minister said.
Minister Ramsammy said that treatment in prison is available as well so there are prisoners today that are getting anti-retroviral drugs. "So when it comes to HIV services, no prisoner is denied, so when we talk about universal access for prevention, treatment care and support, it extends to behind the bars," he said.
Condom distribution against regulations
Speaking on the cooperation between the health ministry and the various agencies that are responsible for the prison system, the minister said that the prison authorities proactively seek out the support of the health ministry.
"We have social workers, counselors and testers, and that requires an extensive amount of facilitation and the authorities have been extremely supportive," he said.
But on the darker side of the prison system, he said that there are some aspects of the programme that are not yet in place. For example, the distribution of condoms, which is against the regulations. He said however this does not mean that condoms do not make their way in the prisons.
"At this time, Guyana does not have an official policy on the distribution of condoms in prisons. Though I am sure they are there, how they get there I don't know," Ramsammy said.
On sex, he said that the evidence suggests that this occurs in prisons, and here he spoke of both consensual and non-consensual. "The evidence around the world suggests that [there is sex in prisons].
The extent to which it occurs in Guyana, I don't know. No studies have been done. I don't know what would make Guyana's prisons different from the prisons in any other jurisdiction," he said. "But like most prisons in the world we do not permit sex in our prisons. Non-consensual sex is a crime anywhere in the world and that should not be permitted in our prisons."
The minister said that all of the talks and other methods of educating prisoners about risky behaviours and the risks of contracting infections would only work in the case of consensual sex and not cases of rape. "But we have to continue to work to reduce the possibility of sex in prisons," he said.
Other health risks
He added that there is a need to also address tuberculosis and other infectious diseases while in prison so that inmates do not become a risk to others when they are eventually released.
With regard to the health risks posed to healthy prisoners, the minister said that the prison authorities and the Ministry of Home Affairs are doing everything they can to prevent sex in prisons — consensual and non-consensual.
"We are convinced that prisoners need to be given access to the means of protecting themselves and reducing their risks, like any other citizen. And therefore the prevention of risky sex in any setting, whether in our homes, in our clubs, in our workplaces, at our prisons must be promoted. What we can do, outside of what the prison authorities are doing to promote safe sex, is that we can educate people."
On the issue of tattoos, the minister said that the authorities have recognized the health risk that this practice poses and have responded through programmes in the prisons.
Panos Caribbean
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